Nightweaning: Evidence and Experience

Artist: Grace Laidlow. Shared here with a donation to the artist.  Art in the Public Domain.  https://www.publicdomainpictures.net/cn/view-image.php?image=211133&picture=

Artist: Grace Laidlow. Shared here with a donation to the artist. Art in the Public Domain. https://www.publicdomainpictures.net/cn/view-image.php?image=211133&picture=

When nighttime sleep has been a challenge for breastfeeding mamas, many will turn their attention to the question of whether night weaning from breastfeeding will lead to a better night’s sleep.

After all, it makes intuitive sense that, as Jay Gordon suggestions, if the diner is closed, there’s no point waking up for a midnight snack.

In this article, we will take a look at what we know about night weaning and explore what may work to support night weaning in an evolutionary and nurturing way.

In addition to exploring strategies for night weaning, I’ll indulge in a bit of storytelling, too, as I share my night weaning experiences with my three children. Most of the suggestions below assume that you are considering night weaning a baby over 12 months of age, and that your toddler is bed sharing with you, or are continuing to room share with you: the effort of continued night feeds for a child down the hall makes it likely that toddlers who are sleeping in their own room are already weaned. Also, night weaning before 12 months has special considerations that include development and growth that I won’t cover in this article.

The challenge for some parents (though not all) that emerges in the toddler years is that as parent longing for some personal space goes up, so does toddler restlessness, acrobatics, long lazy latches, and nighttime nibbling. Nipples get sore, heads get kicked by flailing toddler arms, and toddlers go through periods of increased feeding for comfort, emotional connection, nourishment, and more —nothing close to the straight trajectory towards natural weaning that we pictured when we first imagined natural child-led weaning. It can feel like a return to the early days of feeding, except kiddo is three times as big, and waaaay more active. Parents who are nursing a toddler through the night probably recognize some similarities with nighttime at the 7 to 10 month mark too —a typically challenging period of time for infant sleep.

As decisions are made about if and how to night wean, it can be helpful to keep two questions in mind: what are you reasons? And what are your goals?

I want to emphasize that when we, as parents, have decided we are “done” and want to end the nursing relationship, it is ok! Sometimes this is out of frustration, fatigue, being “touched out”, or wanting some flexibility through the night (to work, to rest, to be alone). As decisions are made about if and how to night wean, it can be helpful to keep two questions in mind: what are you reasons, and what are your goals. The answers to these questions will help guide your actions, and will also help you evaluate things, and change course (subtly or significantly) if what you are doing doesn’t align with your goals. Your goals, of course, may change too!

Often, breastfeeding parents feel that night weaning will reduce night waking. That connection is quite murky —I could find no evidence to support this idea in the literature, though certainly there are some children for whom this is true, anecdotally. I would suggest that in terms of sleeping through the night, it be approached more as a developmental skill, and one that may or may not be impacted by night nursing. However, despite this, moms may still feel a strong pull towards night weaning for their own physical comfort, and their desire for some bed boundaries and personal space. These are important things to honour!

There may be sweet spots that, developmentally, can make it better “timing” —these generally happen between Plooij and van de Rijt’s popular “Wonder Weeks” in addition to other frameworks of developmental jumps. However, timing isn’t everything —your needs are factors here too.

Before we delve into how to night wean, let’s take a peak at what we know about night breastfeeding.

Research doesn’t tell us much about weaning. And research tells us even less about night weaning. What do we know? We know that:

  • up to 1/3 of a child’s nutrition at 12 to 24 months of age can come from night feeding (WHO, 2015);

  • breastfeeding beyond the first and second year of a child’s life is recommended if it aligns with what a family feels is appropriate (CDC, 2014); and

  • night weaning can be among “the most logistically and emotionally challenging” aspects of weaning (Cuniff & Spatz, 2017, p.93)

  • Night feeding and bedsharing are highly correlated

What does that mean for moms who are ready to night-wean? It can be gradual. It can be your decision. And it can be difficult. But, as with many parenting situations, being difficult doesn’t necessarily mean it is not the right decision. Weigh the benefit and draw backs, be flexible, and be gentle with yourself. This, like so many other aspects of parenting, requires flexibility and an open mind.

Weigh the benefits and draw backs, be flexible, and be gentle with yourself.

Here, then, are some insights for those who have decided to nudge things towards night weaning.

One of the more popular suggestions for night weaning parents is Dr. Jay Gordon’s nighttime weaning process (Gordon, 2002). For kiddos above the age of twelve months (and more than likely 18 months and older) who are ready, his process can work well. However, in practical experience, these steps can be difficult, and distressing especially at a younger age —there are gentler, more developmentally-guided approaches. Likely, if his approach (some of which are incorporated in the suggestions below) is not working, it is not good timing: pause, re-evaluate, and try again. It is ok to stop, and wait for a better time. Other strategies that can feel more respectful, flexible, and gentle, are included below and are drawn, in part, from Elizabeth Pantley’s book, “No Cry Sleep Solutions".

I don’t remember many of the details of weaning my first born. I know there were portions of the process that were not easy. And there were a few re-starts, and pauses, and “try agains”. My toddler would rather have nursed, but I don’t recall the transition being an exceptionally difficult one, and the glorious indulgence of a bed I could stretch out in was pure bliss—a welcome focus on my needs after the intensity of the first year and a half of parenting, was nothing short of amazing.

With our second, I was glad to be done with night nursing by about age 2, motivated by my own worthwhile need to have my body be my own at night. It is not a decision that I regret, though I do know there are 101 different choices, options, strategies, and nuances that can make night weaning look different for every child, and every family.

We chose what we felt was best for us, with a great deal of flexibility, and our eye on the big picture: night weaning would happen eventually whether we promoted it or not. A bit of nudging in that direction was just fine. And assertive communication from our toddler was worth evaluating and re-evaluating: was our expectation of him reasonable? Was it best to wait a bit longer? Does this feel right?

We did play some musical beds during this period: sometimes my spouse was the one cuddling our weaning toddler at night, and we did not balk at changing the plan from night to night (or part way through the night!) if what we were doing was not working well for any one of us.

Night weaning generally falls into the “can do, but don’t have to” category of parenting decisions. Weaning will happen over time, even if you do nothing in particular to nudge it along.

By toddlerhood, parents are adapting to the assertive and big emotions from toddlers who don’t (can’t) always have their needs or desires met in precisely the way they would like them to be met: no matter how much they want to, they cannot run across the road, smash a glass on the floor, or hit their sibling. Night weaning, however, generally falls into the “can do, but don’t have to” category. Weaning will happen over time, even if don’t do anything in particular to nudge it along. If the timing is right for you, it’s a matter of balancing needs, and moving flexibly and sensitively towards your goal.

Keeping an open and flexible mind allowed me to use our toddler’s room for night weaning. The time spent with him at bedtime and through the night helped me figure out what parts of night weaning were workable, and what parts needed tweaking. There were many missteps (the bruise on my forehead from a sippy cup thrown in frustration by my toddler being one of them). My “in the moment” goals around night weaning shifted depending on how tired I was. What felt most important to me was to honour the ebb and flow: to know that I was not “giving in” if I chose to breastfeed him, and to know that weaning would happen eventually. Night weaning when mama is ready, but baby isn’t quite on board, is an exercise in respecting everyone’s needs, and finding solutions that work best under the circumstances.

With our third, I needed to be on medication that, based on multiple sources, required weaning. It was, quite frankly, an awful process for both of us, as neither of us was ready: I had had my intentions to night nurse for longer than I had the other two, and the sorrow and frustration we both felt with early weaning was heavy. If you are experiencing a similar situation, Dr. Jack Newman’s International Breastfeeding Clinic is a highly recommended resource for working out the necessity of, and the details of, weaning due to medical/medication needs, particularly with the closure of Sick Kids’ Mother Risk organization. If night weaning is not your personal goal, but appears to be medically necessary, gathering all the support you can to make a workable plan. This may include strategic, professionally-supported timing of medication, as well as validation of your feelings through this process, and practical strategies for paving the way.

Nurturing strategies can be applied to make the process of weaning smoother.

If night weaning is necessary, know that sometimes there are factors beyond your control, and that you have many other nurturing strategies at your disposal for maintaining a strong bond with your baby, even if circumstances (medical or otherwise) lead you to night wean before one or both of you are ready. Know as well that if night weaning is right for you, these nurturing strategies can be applied to make the process of weaning smoother, and respects the emotional well-being of both you and your baby.

If night weaning is chosen for your own well being, know that that is an important reason in and of itself. Night weaning before a child is ready can be challenging, and pulling in all the supports and strategies you can is important, too.

The following are some strategies to consider when night weaning your toddler.

Strategies for Parents Who Feel “Done” with the Nighttime Feedings:

  1. Reflect first. Is this feeling like a permanent shift in your feelings around nighttime nursing? Or is this feeling a blig in the road? Are you doing this for you (great! If it’s not working change it. Your priorities and preferences matter!) or is there pressure from others? I use a nighttime weaning readiness checklist with clients to explore this further.

  2. Eliminate barriers! Reflux, excema, tummy issues, and respiratory difficulties (apnea, environmental allergies, stuffy noses) can lead to frequent night nursing to relieve discomfort. Addressing these issues, and resolving them as best we can, paves the way for meeting night-time weaning goals. Occasionally something as straightforward as a diet change or fresher air in the bedroom can improve sleep, and make night-time weaning easier.

  3. Change it up: the bedtime order of breastfeeding and cuddles may not have a huge impact on overnight feeding, but it can help some parents feel that they are moving in the right direction. Toddlers may wake up sooner when they first shift away from nursing to sleep (we don’t really know —and some toddlers coast right through to the usual next wake up). Regardless, with the right routines in place, and an approach towards flexibility and gradual separation of nursing and falling asleep, your toddler may surprise you with their readiness.

  4. Close up shop: in the early days of breastfeeding, nursing shirts and button pajamas make it so much easier to breastfeed. If you are looking to wean, a change of clothes may be helpful. By switching to pull over shirts you’ve created a mild inconvenience; not enough to dissuade a child who continues to need the breast at night (physically or emotionally), but enough that a child that could take it or leave it might decide it’s not worthwhile. Button-up pajamas on backwards never appealed much to me, but by the time I was ready for nighttime weaning, the buttons on my pajamas were so loose that I may have seemed to have a flashing (no pun intended) neon sign that said “no need to knock: the door is already open”.

  5. Different space, different parent: Shifting primary parent at night to your partner, and potentially to a different room (a twin mattress floor bed in a toddler-proof room, for example) can allow for some musical beds. For a toddler who is ready, the different caregiver and different environment can make the shift through night weaning easier. A favourite sippy cup of water might help too, and expressed breastmilk in a bottle may help bridge the change.

  6. Shorten the meal: Keeping the nursing time to shorter and shorter intervals can still give toddlers the comfort they seek from the breast, while reducing how long they are on, and giving them the opportunity to adjust to coming off the breast before falling asleep. Your toddler will let you know loud and clear if they are ready for this! Adjust the interval if it’s not working as well as you hoped.

  7. Shorten the hours: Choosing a window of time when the diner is closed can work well for some kiddos. Some parents have “closed” one breast, and have found that the lower flow of the other breast has led rather smoothly to less interest in nursing.

  8. Use language to bolster your plan! Sometimes as parents we forget that our words, and tone of voice matter. In addition to reading picture books about night weaning, and explaining what to expect (in clear, simple words), having a short phrase to say at night as you unlatch or as you turn down a request for nursing, can have a profound effect. Not only is your voice one of the nurturing nighttime tools you have, but the combination of your simple, and soft words, with your actions can help move the process of night weaning forward.

  9. If it’s not working, it’s ok to pause, and re-evaluate. Sometimes timing is everything. I know how challenging it is to set your mind on something, and then have half a dozen other factors completely knock over your carefully laid plans: two year molars, a move to a new room at daycare, family vacation, and illness, can all make your dream of a night without nursing seem impossibly difficult to achieve. Pause, re-evaluate, and try again. No parent should feel they need to continue night nursing when they feel “done”, but it is ok if it is a jerky walk to the finish line: be gentle with yourself through the ups and down, and look at the trajectory over time.

As with all stages of childhood and motherhood, weaning is a natural and expected part of the mother/child relationship. As babies become older there is a shift more towards balancing the needs and intentions of both mama and babe. It is ok to move towards night weaning when you are ready. And like so many other aspects of mothering, it is a dance: with some back and forth, a shift in who is “leading”, and the occasional toe might get stepped on! You are both on the dance floor together, but sometimes mama gets to pick the next song.

RESOURCES:

Picture Books on Weaning/Night-Weaning

Havener, K. (2013). Nursies When the Sun Shines: A little book on night weaning.

Susan, M. & Low, H. (illustrator) (2018). A Time to Wean.

Saleem, J. (2014). Milkies in the Morning: A gentle night weaning storybook.

Parent Books on Night-Weaning

Wessinger, D. et al. (2014). Sweet Sleep: Nighttime and nap time strategies for breastfeeding families.

Gordon, J. (2002). Good Nights: The happy parents’ guide to the family bed (and a peaceful night’s sleep!)

Pantley, E. (2002) The No Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night.

Plooij, F. & van de Rijt, H. (2010). The Wonder Weeks: How to Stimulate Your Baby's Mental Development and Help Him Turn His 10 Predictable, Great, Fussy Phases Into Magical Leaps Forward.

Online Resources

Bonyata, K, Flora, B., & Yount, P. Night Weaning, www.kellymom.com.

Sears, W. & Sears, M. Night Weaning: 12 Alternatives to the All Night Toddler Nurser. www.askdrsears.com.

Peer Reviewed Articles

CDC (2014).

Cunniff, A., & Spatz, D. (2017). Mothersʼ Weaning Practices when Infants Breastfeed for More Than One Year. MCN, The American Journal of Maternal/Child Nursing, 42(2), 88–94. doi:10.1097/nmc.0000000000000310  Accessed online June 13, 2019.

World Health Organization (2015).

Camp Cooking: "Feeding With Love and Good Tents"

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Camp Cooking: How to Feed the Kids with Love and Good Tents

ONE OF MY FAVOURITE BOOKS...

...about how to feed children is Ellyn Satter's "Child of Mine: Feeding with Love and Good Sense".  Her approach to a healthy division of responsibility for feeding children is a classic, and guides me in more than just meal preparation.  But sleeping in tents doesn't mean saying bye to good sense.

After weeks of camping with my three boys over the past two summers I've figured out a few things about what to make us for dinner and how to handle the groceries and refrigeration.  How to have freedom and fun with food, while not giving up on the wholesome ingredients my kids need to feel their best.  In the summer spirit, I'm taking a break from infant development and infant sleep blogs to throw a few ideas down on paper about daily life for camping families: what to feed the kids and family.

A few assumptions:  I'll assume that meat is on your menu (because if it is not, you can ignore that advice). 

I'll also assume you are not camping in a group and aren't combining resources (because, again, you can ignore my advice and combine kitchen tools and menus as a group).

I’m assuming, as well, that you are car camping. Overnight canoe- or hiking- trips are wonderful adventures, but I’m focusing here on families who are venturing into camping with kiddos, rather than those with a lot of experience back-country camping.

And last, I'll assume you are trying to pack minimally: pots will get reused in the same meal, tools will tend to be multi-purpose or really worth the space. There is something really liberating about only having what you need.  What you don't have (or what you forget) will usually have some adequate substitute that will make you feel like a powerful pioneer woman, or like a “social connection seeker”, asking the next campsite over if they can lend you a lighter or pair of scissors.

So, here are a few basics:

  1. Bring the right tools, but no extras. Your car will be full enough with sleeping bags and a tent and pillows. Pay attention before your trip on what tools you use for what meals and start a list: Vegetable peeler, tongs, sharp knife, can opener, flexible cutting board --there are work-arounds for all of these, but they are also quite handy items that can make your trip go more smoothly.

  2. The exception to “bring no extras” is propane or fuel for your stove. Bring more than you need or know where you can get more. Until you get used to how much fuel you need, it may be better to have extra for next time than to run out. If you are a large group or are camping a long time, consider getting an adaptor for your stove so that you can hook it up to those large white propane canisters that you use with your backyard barbecue. Note: on windy days you will go through fuel much much faster.

  3. Eat meat early in the trip; focus more on vegetarian meals leading up to pack-up time or grocery trip day.

  4. Two smaller coolers (one for meat, one for veg) may be better than one large one. Also, I find a full cooler with block ice is very difficult to take in and out of the car safely: dividing your food into smaller coolers may help you when it comes time to tuck the coolers away for the night.

  5. Put your cooler in the car. I have occasionally partially 'locked' the cooler under a picnic table bench but that was in campgrounds where there were no seasoned racoons or skunks. Or bears. Better to be safe and still get breakfast in the morning than to attract unwanted guests. This general philosophy applies as much to urban car camping as it does to isolated backcountry camping.

  6. Check the plug on your cooler to ensure it is secure: a puddle of water in your car in the morning, or ants in the drained cooler is no fun. A trip to the home improvement store for silicone is no fun either but it will work if your plug breaks off and you need to McGyver it. (Not that this has happened to me).

  7. Opt for block ice if you are going for more than a day or two. The ice lasts much longer.

  8. Keep meals simple but nutritious. There's lots you and the kids may want to do while camping, and fueling your bodies well will help!

  9. Pay attention to what your family eats as you plan your trip. You may find that some of your regular meals are easily made while camping. Others can be modified.

  10. Don't sweat the normal routines. If bedtime snack is a major theme in your house, know that when camping the kitchen will literally be closed when you close up your car for the night. Many kids have an amazing ability to adjust to limits in choices and restrictions because the camping environment just doesn't support what can happen more easily at home. For those kiddos who have a difficult time with changes in routine, keep it simple and pay attention to the key rituals (is it the type of food they focus on, or is it something else like one on one time with you that is the clincher?).

MENU IDEAS:

BBQ PIZZA 

Sautee onions, peppers on a fry pan.  Add small stir-fry size chicken (or meat alternative) on pan.  Remove from pan.  Pan-heat soft tortilla shells (gluten free, regular...whatever fits your family's diet) with gouda (or alternative), barbecue sauce, the chicken and veg until cheese is melted.  Slide off onto places, cut into triangles, and eat.

PASTA:

Cook your pasta of choice in large saucepan.  On a separate burner (or afterwards if you don't have two burners free), saute onions, peppers in fry pan with oil.  Add ground beef or alternative, stir until cooked.  Strainers are nice but you can also adequately drain pasta with oven mitts and the lid on, and a slow pour down at ground level.  A bit of grass is usually ok :)  Empty pasta into a large bowl.  Put beef mixture into now-empty saucepan and add tomato sauce.  Heat.  Add into drained pasta.    Pasta can be cooked ahead of time if time will be tight for dinner.  

TACOS:

Cook ground beef, chicken strips or alternative ground protein as you do for pasta.  Add taco seasoning (we ditch homemade and bring the Ol' El Paso stuff for camping).  Slice avocados and cherry tomatoes, cut some lettuce, and get out the shredded cheese or alternative.  Bring a jar of salsa, whatever taco shells (or romaine lettuce wraps) you like to eat, and !Ahi Esta!, you've got a meal!  

BREAKFAST:

Either keep it simple: favourite cereal, with milk.

Medium grade: instant or quick oatmeal with nut butter, raisins and seeds.

Or heavy duty: Scrambled eggs and pre-cooked bacon.  You can cook the bacon the night before or when you first get up.  Chop extra peppers and onions the night before to add to the omelette, and hopefully you have extra cheese too.  Bacon is messy, and I tend to avoid it when camping.  I recommend buying eggs in plastic cartons or using the camp coleman-style egg containers: cardboard gets soggy in coolers.

You can also pre-mix the dry ingredients for pancakes and add eggs and liquid when you are preparing breakfast.  Bring nut butter, jam, syrup, or honey.  Or all four!

LUNCH:

We approach lunch as a light, cold, picnic-y meal so that you can make it quickly, pack it in a backpack, or graze between swimming, playing frisbee, or relaxing.  Of course, any dinner ideas work for lunch too if you are hanging around the campsite at lunch time.

Bring romaine, croutons, and Caesar salad dressing; use left over beef, chicken, or other protein from the night before (requires making extra or having kids that are too busy having fun to eat all their dinner --this happens a lot to us while camping).  Store extra meat in sealed container in cooler.

Prepare humus, tortilla chips, guacamole, cucumber, peppers, cauliflower, baby-cut carrots, and any other vegetable that will fit in your cooler.

Have nuts, seeds, raisins, and other trail mix options for hikes, or for hungry tummies while you make lunch.

Bring cold cuts if you eat processed meat.

Have easy warm meals for cooler days: instant or quick cook oatmeal with nut butter, macaroni and cheese (even if you forget the butter and milk), hot dogs if you have a barbecue, canned soups.

SNACKS and DESSERTS:

Bake muffins and cookies ahead of time.  Bring graham crackers, good chocolate, and marshmallows for S'mores.  I've tried the 'prepackaged' S'mores and they were very stale.  Perhaps that is not always the case, but it's not an experiment I want to run again!  If you have kids that are greatly affected by sugar or who go to bed too early for a fire, consider S'mores for after breakfast: for kids, the memories will be great whether the special camping rituals are after sunset or during the day.  Marshmallows can be cooked over a barbecue if there is a fire ban or if smoke allergies are an issue (Mother Earth will thank you, though I do know how lovely a crackling fire is for the camping experience).

If you like kitchen hacks while camping, consider lining a cardboard box with foil and place coals or hot bricks in the bottom to make an oven for baking.  

PACKING YOUR KITCHEN KIT:

One of the pleasures of camping for me is the isolation and (even if urban camping) my expectation is to avoid stores unless absolutely necessary.  As a result, I do my best not to forget anything critical.  And usually I manage that!

Some things, for me, are a must.  Others are an indulgence.  Take what you need, create a bit of a buffer, and leave the rest at home.  Usually, as long as you have the basics, you can make do missing a thing or two.

take a deep breath, and Have fun.

Camping for our family has meant an immersion in simplicity, a realization that our family priorities sometimes are at odds with our modern life, and that having nothing to do is a big blessing. There can be pressure to think that we need to plan our time. Limit your planning to getting there, and let the rest take shape. Let the experience (rained out barbecue, and leaky tent included) be an exercise in letting go, and giving nature her due: we try to control so much in our lives, that taking a deep breath and accepting what comes can be a welcome shift.

If you’d like to learn more….

Join me June 29th in St. Catharines for a presentation that is part slideshow (photos of Ontario and American Southwest camping with our kiddos), part how-to (more menu ideas, kit lists, and lessons learned), and part environmental imperative (a perspective on environmental illness, including guidance for preventing Lyme Disease).

Sign up here to be on the RSVP list for June 29th (you will also receive my weekly newsletter) or email me at heather@heatherboyd.ca to RSVP.

Let’s get camping!

Bridge to the Next Connection

autumn bridge 35aa20781999d47d04767e4d61be6f56  pxhere .jpg

Bridging to the next connection is an attachment-based strategy for separating from a child in a way that reduces anxiety and resistance, and respects a child’s developmental and emotional ability to separate. The concept of bridging to the next connection was developed by Dr. Gordon Neufeld, Developmental Psychologist from British Columbia who co-authored the book “Hold Onto Your Kids”, and whose Neufeld Institute runs courses on understanding the emotional and attachment needs of children. Bridging is a strategy for separation that I have used as a parent, and have recommended at my workshops and private consults. It can be a tricky concept to get the hang of, and so I am describing it below so that parents who feel their child is ready for separation at bedtime have a developmentally-sensitive and attachment-oriented way to nudge their toddlers and preschoolers towards more independent sleep.

Bridging is a strategy that can pave the way for all sorts of separation situations including the separation to school, for a sleepover at grandma’s house, time with a co-parent, and even getting yourself out the door for much needed solo time. I’ll focus here specifically on using bridging as a strategy for solitary sleep in toddlers and older children but have included two children’s books in the resource list that address a broader idea of separation. Despite its usefulness in a number of scenarios, bridging is a particularly useful strategy for parents who are working towards leaving their child’s sleep space while their child is still awake, with the expectation that the child will stay in the bedroom and fall asleep on their own.

The premise of bridging to the next connection is that by focusing on being with, rather than leaving, you help your child relax because they trust you will return. The focus is on reconnecting, not on leaving. Children are more likely to fall asleep alone when they can relax in the knowledge that you will return before they need you. They will, in effect, not be chasing your attachment literally right out of the room when you get up to leave.

Although the concept works well in practice, it is somewhat difficult to explain and does require hitting a bit of a sweet spot in the yin and yang of meeting a child’s nighttime needs. So here are some ways to approach bridging, and ideas on how to implement it with your three year old or older child.

To pull off this bit of bedtime magic effectively, be in a place of surrendering to the present: you are in your child’s room, so bring your brain and future self back upstairs and be there with your child! I know this is easier said than done, but when your thoughts are on dishes or the email you need to return, or the thirty minutes you will relish when you finally can kick up your feet and watch TV, your child will know you are not fully in the room with them…And they may not relax enough to fall asleep.

When you are in the room at bedtime and are fully present and focused on being there, do not check your phone, or check the time. Fully suspend the thought around how soon you can leave! After finishing off any bedtime routine in ways that bring joy and calm to both of you, it is now time for you to leave. But the focus is on coming back. Yes. Just when you are feeling so close to escaping from the room after a very touched-out day, focus instead on when you will return. Tell your child you are going to step out of the room for one minute, and describe to your child what you will say when you come BACK (“I’ll come in to tell you I love you”) or what you will do (I'll tuck you in again, I’ll cuddle with you till you fall asleep). Tell them to listen for you to come back and that when you do you will be so glad to get one more hug before they fall asleep.....Then leave for as short as you need to (10 seconds? A minute? Five minutes if they -and you- are good at this) without her calling out for you. Return before she worries you aren't there. Then build from there.

What will you do while you’re gone? Go pee. Wash one dish. Tidy the bathroom counter. It’s likely worthwhile staying away from email (we know how time magically disappears when that happens!). Do anything that is short, is verifiable (they hear you), and is easy to end early (a good long pee aside). Then return before they call out! Return early as a way of shoring up their trust in you, and as reinforcing your promise to return. They may not be sure you will return initially, especially if bedtime separations have been rough in the past or they have never fallen asleep on their own. But build slowly (step into the hall to blow your nose every night if that will help) and over time you can grow their trust and help them relax in the knowledge you are coming back.

How does this actually look in practice? When our son was three and our second born was still an infant, we were desperate for a bit of separation from the bedtime routine of staying in his bed until he drifted off. I would like to say we wanted that time to relax together, but truth be told we were thrilled by the idea of cleaning the kitchen together which, I’ll point out, was actually a wonderful way for us to work together and connect at the end of the day. I had just completed Gordon Neufeld’s Making Sense of Preschoolers online course and the idea of bridging to the next connection made so much sense in terms of his development (separation anxiety was high!) and his needs (he had a great deal of difficulty falling asleep without us there).

We went through the regular routine and then I, not without trepidation, said “I’m popping out of the room for a glass of water. I’ll be right back”. And then I left. It was short, and I returned before he called out.

When I returned, I stayed with him as usual until he fell asleep. The next time, I left twice, and attempted to leave for more than a minute. It worked!

Until it didn’t. The third night I was over zealous perhaps, and thinking of what I could get done after I left. Or perhaps he just needed me more that night. Regardless, I was staying out of the room too long, and he was not relaxed enough to fall asleep, even coming out of the room before I got to the end of the hallway. And so, as we continued working on this separation gradually, we ebbed and flowed with the idea that some nights would be easy peasy, and on other nights his need for our presence would be high. When these higher-need nights happened, we suspended our expectations that this was a straight trajectory. Nothing in parenting seems to be, except the straight trajectory of our child following us out of their room when we want them to stay in bed!

I gradually, and with various excuses, left the room for progressively longer time. Within the first week, I was leaving the room for about 5 to 10 minutes at a time, and returning to a kiddo who was awake but calm, in bed, and happy to see me. I recall there being a joyful “you came back!” look on his face, happy that his faith in me returning was warranted. By about the fifth visit (and occasionally the eighth or ninth), he had drifted off to sleep, confident I would return as promised.

There were nights, in the coming weeks, that he called out soon after I left. There were other nights when I forgot to return, and he would call out wondering where I was. Yet more and more frequently, he would not call out at all, I would return once or twice, and be pleasantly surprised to find a peaceful sleeper with nary a peep of protest.

On the nights that he drifted off to sleep and I remembered an hour later that I hadn’t returned, I made sure to pop up and peak in on him, and to tell him in the morning how nice it was to come in and see him sleeping so soundly, and to whisper I love you. “Did you hear me in your dreams?”, I’d ask him? He never did, but I like to think that his knowing I came to check on him reaffirmed his feelings of safety and love we wanted to give him.

We have continued to use this approach for all of our kiddos, sometimes with great success, and other times not so much. When it hasn’t been working, it usually has been for one of two reasons:

  1. We were already “out of the room” before we left, and our kids knew we were not present and focused on them.

  2. Their needs were higher on a particular night (impending illness, a rough day, overtired, wound up) and we hadn’t adjusted our night time routine to accommodate that.

When it wasn’t working, we didn’t throw the idea out the window. We did our best not to become authoritarian and threaten separation (“You HAVE to stay in that room or I am not coming back!”) —that, if you didn’t notice, is about the polar opposite of what bridging is trying to do.

To this day, when the boys ask us to stay with them to fall asleep we know that for some reason they need us more that night, and we do it (mostly) with an open heart. But more nights than not we can check on them a few times after lights out and find that like candles burning themselves out, the boys quietly fall into a relaxed sleep at some point when we are not in the room; even when they are certain they are not the least bit tired and will still be awake when we come check on them.

And that, for us, is a parenting win.

References:

Tamara Strijack, Bridging the Night: Untapped Magic (online blog article)

Neufeld Institute, Making Sense of Preschoolers (online course)

Patrice Karst (author) & Geoff Stevenson (illustrator) The Invisible String (published children’s book about separating from a parent at night and during daytime, and through death of a loved one).

Audrey Penn (author) & Ruth Harper (illustrator), The Kissing Hand (published children’s book about separating from a parent to go to school)

Deborah MacNamara (2016). Rest, Play Grow: Making Sense of Preschoolers (or Anyone Who Acts Like One). Published book based on Neufeld’s Making Sense of Preschoolers Course.

Your Environment Matters

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This month I am pleased to be attending a conference of the International Society for Environmentally-Acquired Illness in Arizona.  The conference will build on my knowledge of chronic illness from mold, water-damaged buildings, lyme disease, and tic-borne illnesses.  As one of seven Canadians, and the only Occupational Therapist in the Society I am aware of how little information is available in Canada on environmental illness, and how difficult it is to find practical support and accurate information on environmentally-acquired illness.  I am eager to develop resources to support families who are concerned about indoor air, and environmental health.

As an OT working with families and young children, I understand the impact that our environment can have on infant and child development, and am enthusiastic about supporting families to improve their environments to support health and wellness.

Environment encompasses an important part of my assessment and work with families, and this conference will build on this knowledge set in order to better support families who suspect that environment is one component of the challenges that they are experiencing.

With Earth Day having just been celebrated this week, and with our attention turning to ways we can reduce our impact through environmental action, I cannot think of a better time to put environmental health and environmental illness front of mind.

Neufeld’s Six Stages of Attachment and What They Mean for Bedtime (Part I: Stages 1 to 3)

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My favourite Canadian developmental psychologist, Gordon Neufeld, outlined six stages of attachment to explain the development of attachment in children. I have found these stages helpful as a mom in knowing what emotional and attachment needs my boys could be expected to have, and how that can shape my parenting. Knowing the stages has allowed me to anticipate their needs better over the years, and has helped me understand their behaviour better too, something that any parent of a toddler will tell you is a bit of a miracle!

The stages that Gordon Neufeld describes are:

  1. Proximity

  2. Sameness

  3. Belonging or Loyalty

  4. Significance

  5. Love

  6. Being Known

As I watched my first two boys move from stage to stage, almost exactly as Neufeld described, I was awestruck with the idea that something as seemingly “soft” as attachment could be so predictable. I was also well aware that the attachment I was seeing emerge from them would form the basis of every healthy relationship they have in their lives. My third kiddo, somewhat obscured by the busy-ness of life with three boys, has benefited greatly from my understanding of the natural progression of attachment, while at the same time I have paid far less attention to the details. Despite my lack of attention, the stages of attachment have marched on anyway. I can say, though, that anticipating each stage, and reveling in this natural emergence of attachment, is really rewarding.

Here, I outline the first three of Neufeld’s six stages of attachment and describe what each stage may look like, and how parents can respond to the needs of their child at each stage.

In general, the six stages of attachment correspond to age in years. Developmental and neurological challenges, trauma, illness, and separation can all have an impact on the timing of these stages —and when this is the case, understanding these stages can be helpful for establishing attachment on a child’s own timeline. It is useful to appreciate that the stages of attachment are worth working through gradually, at a child’s pace, and with the intent to ensure the needs at each stage are fully met. It is also helpful to appreciate that we can be grown adults and still have needs that correspond to earlier stages of attachment, particularly if we have had negative relationships early on in our lives, or have experienced trauma and adverse childhood events. Babies don’t entirely abandon earlier needs (e.g. the need to be close), However, Neufeld feels that the better a child’s attachment needs are met, the more easily they will be able to move to the next stage of attachment. It is never too late.

It is also helpful to understand that attachment is “in the present moment”. Attachment can be temporarily ‘broken’ if we are distracted, angry, or disconnected, or if our children are frustrated, overwhelmed, or angry. And attachment that has fallen apart earlier in the day can be re-established through connection, empathy, and attention. By focusing on re-establishing our connection with our children “in the moment”, we can re-establish the bonds of attachment. In practical terms, this means bedtime can be wonderful one evening and then feel like it is falling apart at the seams on another: look at ways to reconnect at your child’s level, if things feel disconnected. It also means that bedtime can be a wonderful time of day to repair attachment: focus on slowing down, listening, paying attention, and reconnecting during the bedtime routine to finish the day with strong, secure attachment.

STAGES OF ATTACHMENT

  1. Proximity (1 year old)

What it is:

  • The need to be close, to touch you, to be touched by you, to be nearby, to see you, to hear you, to smell you.

What it looks like:

  • Babies will curl into you, reach out to you, cry when separated from you, be soothed by skin on skin contact with you, and have an easier time regulating with touch, breastfeeding, being held, or being carried.

How parents can meet this need:

  • Expecting babies to need to be close to you can help set reasonable expectations in the first year and beyond. Ways to meet this need for proximity include babywearing, roomsharing, holding, rocking, breastfeeding, bedsharing, and orienting yourself to hold baby for bottle feeding in ways that mirror breastfeeding (skin on skin, frequent cradling, considering having one primary ‘feeding person’ for bottle feeds) can all meet this need. Hugs, and squeezes, horseplay and cuddling are all very physical ways to meet this need. Using your soothing voice, your eye contact, or even remaining visible are all ways that help babies relax through your proximity.

  • As babies become more mobile, they will begin to move away from you but will circle back to you for proximity in order to get reassurance, particularly when unsure in a new situation. As they get older, this ‘circling back to you become visual: they will turn to check that you are still there.

  • By ensuring the need for proximity is met, we are reassuring our babies that we love them and are taking care of them.

2. Sameness (age 2)

What it is:

  • Two year olds tend to want to be like the people they love.

What it looks like:

Your child will mimic or imitate the behaviours, actions, and words of you and other very key caregivers (usually one or two key adults). Two year olds love to imitate household activities, facial expressions, gestures, and mannerisms. Children will often show an intense need for sameness of one caregiver over another at certain points in time. This may be difficult for the other parent or caregiver who can feel rejected and not understand why: the intensity of attachment is so great that it is often directed really strongly to one parent. This changes over time, and requires patience and understanding that it is typical.

What parents can do to support this stage:

  • Take pleasure in this imitation. Be playful with it. Model calm self-regulation, and share in these imitated activities as much as you are comfortable with. Enjoy this shared behaviour, and know that this imitation indicates a strong attachment to you. Encourage your two year old to help you around the house: wiping windows, folding cloths, using utensils, putting toys away. Imitation is a powerful indicator of attachment, but it is also nature’s way of setting the stage for behaviours that we come to expect our children to have. Know that if you are a loving parent who is not the object of this imitation, your presence, consistency, and love will lead to this happening: it is worth the wait!

  • At bedtime, create some ‘sameness’ with same physical belongings like pillow cases or even two stuffies that are the same (one for you and one for your two year old!) if you sleep apart. Same pajamas can also be a fun way to build on this stage.

  • The same routine, and reveling in that routine, can be a powerful way of providing security and predictability for your two year old. The same book, the same chair, and the same tuck in routine each night lets your child know what to expect.

3. Belonging/Loyalty (age 3)

What it is:

  • A strong sense of acceptance as a family unit to you and one or two other key caregivers.

  • A sense of you ‘belonging’ to your child. This can feel like ‘ownership’ or possessiveness, but is based on a strong sense of unconditional belonging.

What it looks like:

  • This stage can be clear to see when our children start using the phrase “my _____”. “My mommy”, “my cup”, “my toy”, and “my baby” are frequent at this age. Often, this age coincides with the birth of a baby which can make children feel even more possessive of parents and cherished things. Eventually, this sense of belonging extends to the new baby too, though this takes patience and time to get there!

How can parents support this stage:

  • At bedtime, belonging and a sense of loyalty can be supported through continued bedtime rituals that strengthen your child’s sense of safety and unconditional love.

  • Urie Bronfenbrenner, father of attachment, has said that every child should have at least one adult who is crazy about them. Enstilling a sense of unconditional belonging supports this stage of attachment.

  • Leaning into the need for your presence and for feeling the need to belong allows a child to relax in the reassurance that you and they are a family unit. It may also help them feel, over time, less concerned about how a new sibling can threaten this feeling of belonging.

  • This is a great age to consider shifting children to their own bed or own bedroom. Pulling the space together for them and focusing on phrases like “your room” and “your bed” can be helpful. Follow through by respecting that space and protecting their space from siblings in order to maintain this space as something that belongs to them.

In closing:

Consider these stages ‘signposts’ of attachment development, rather than as set-in-stone measures of attachment. Use them to guide your parenting, to anticipate your child’s needs, and to take pleasure in the ever changing emotional landscape of childhood! It can be quite a ride.

Next month I will add stages 3 to 6. If you don’t want to wait, you can view my 5-8 minute videos describing each stage of attachment via my facebook page. Stage #3 is a stand alone stage pinned at the top of my facebook page, but the rest of the videos are all in a folder together (securely attached!).

If you want to understand more about how to use the Stages of Attachment to strengthen your child’s sleep routine, or want to explore other shifts in parenting and the environment that can support infant sleep development, I welcome you to connect with me via email or phone.

If you want to read or learn more about Gordon Neufeld’s approach to attachment and child development, I recommend his book, Hold Onto Your Kids (co-authored by Gabor Mate). I also highly recommend the online courses offered through the Neufeld Institute, most especially Making Sense of Preschoolers.

Guest Writing on Motherhood and Sleep Deprivation

I have been less active on the blog front lately, but have certainly still been writing.

You can find my most recent writing in the following places:

  • Kathleen Lockyer’s RxOutside.com, a website and Occupational Therapy practice dedicated to using access to nature as a means for improving health and wellbeing. (March 11, 2019).

  • Rachel Marie Martin’s FindingJoy.net compilation from writers and entrepreneurs on what we would tell our 20 year old self about motherhood. (February 4, 2019).

And soon, a review in Occupational Therapy Now magazine of the book “Broccoli Boot Camp”, which focuses on evidence-based strategies for solving picky eating. This book adds valuable strategies to my approach to supporting families when mealtimes are not going quite as well as they pictured.

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Book Review: Sweet Sleep -Nighttime and Naptime Strategies for the Breastfeeding Family

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La Leche League’s 2014 book, Sweet Sleep: Nighttime and Naptime Strategies for the Breastfeeding Family, is a book for families of infants which focuses on attachment-oriented research evidence and strategies for understanding and addressing sleep challenges.  The intent of the book is to provide breastfeeding-friendly infant sleep knowledge, support, and problem-solving and, as I describe below, the authors have succeeded in meeting this aim.  

Writing in a calm, articulate manner, Weissinger, West, and Pitman are appealing to educated and informed parents who are at least somewhat familiar and open to attachment-based parenting approaches to sleep.  Likely the La Leche League publication naturally draws the attention of those already inclined to providing nurturing measures, in general. Although not an academic paper, the level of education required is rather high.  The book’s strengths lie in its use of evidence and research balanced with clear descriptions and case studies that highlight the key points.

It is quite a lengthy book that takes several hours to read, something that may be a challenge for all but the most motivated sleep-deprived parents.  Despite this, the depth and quality of the information and evidence provided make this my new primary recommendation to clients who are keen to read about infant sleep. Unlike other books on infant sleep, this books looks specifically through the lens of breastfeeding. However, it is still appropriate for non-breastfeeding families if shared in a sensitive way to those not currently struggling with breastfeeding or with previous decisions/necessity of weaning.  There is enough valuable information to firmly entrench this as an infant sleep book for professionals to consistently draw from when providing eager parents with detailed information or references scientific evidence.

Reading this book now, as a weaned mother of three children who now sleep well, I was so excited about the evidence they include that supports attachment-based sleep support for families.  In particular, their section on bedsharing (detailing La Leche League’s Safe Sleep Seven principles) is both evidence-based and instinct-focused: you, as a parent, must weigh the information available to you in the context of your own infant, yourself, and your family.

The references and citations are the real strength of this book.  Subtitles and indexing make it fairly easy to navigate the kindle version. The richness of the content makes it likely that families would benefit from a print version, rather than kindle version, in order to mark particular sections and to use the index more freely. I suspect most families who are so inclined will have print versions decorated liberally with sticky notes.



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Let's Talk About Pee.

Mannekin Pis, bronze statue in Brussels, Belgium. Pixabay.

Mannekin Pis, bronze statue in Brussels, Belgium. Pixabay.

After sleep, and perhaps after discipline, potty training is next in line as one of the likely questions you’ve had (or will have!) about raising your wee ones. Aside from it being a rite of passage for our kiddos, moving beyond diapers is also a big leap for us as parents. When our children stop using diapers and start regularly using the toilet:

  1. We cut down on purchases and on garbage (extra garbage tags, anyone?);

  2. We spend less time dressing and undressing, wiping, and washing the kids.

  3. We have more freedom on outings, even if initially we are simply trading diapers for a portable potty seat.

  4. And we can relish in a significant milestone that shows us our little ones, regardless of how many other ways they need our support, are developing and growing up.

Getting to that point of diaper free, however, is not like stepping through a single doorway. Just like with infant sleep, it is a developmental skill that is complex and cannot be rushed without consequences. Below are strategies for approaching toilet learning with kiddos. And, as with all things parenting, we can begin setting the path right from birth.

  1. “R.E.S.P.E.C.T.”. Awareness of and respect for one’s own body (and all its bodily functions!) starts with how others treat us. Telling your little one what you are doing as you do a diaper change is a simple and yet helpful way of reminding us (and teaching our children) that we respect them.

  2. Pay attention to patterns. Whether you approach peeing and pooing from the perspective of Elimination Communication, or whether you have a toddler with longer periods of time between wet diapers, or an approaching enrolment date for kindergarten, being aware of body language, timing, and triggers (how many pee-infused baths have your kiddos had?!) is helpful.

  3. Each in their own time. Although there are general trends on when children are able to use the toilet regularly for peeing, the age at which children are ready varies so widely that these age ranges are usually not helpful. With the exception of identifying medical, neurodevelopmental, and emotional barriers to toilet learning, the age when most kids are toilet trained may not be helpful in appreciating when your child is ready. Paying attention to signs of readiness, instead of age, can be helpful for taking the pressure off and for respecting your own child’s development.

  4. Model the outcome you want. Kids who see how the toilet is used are more likely to imitate its use, even at the age of one. Consider pointing out why you are using the toilet, and perhaps even invite your toddler to flush! But be prepared that modeling your behaviour might transfer over to putting other things in the toilet —a plumber once told me that in one troubled toilet he found an entire mini collection of playskool people. Pens are surprisingly effective at causing all sorts of back ups (this from personal experience —oh what chaos one little pen can cause). And no one wants their toothbrush to make its way into the bowl. Take it in stride. And keep a plunger nearby!

  5. Offer it and they will pee. Eventually. Having available a potty or an accessible toilet seat (including this one that is built right into the adult seat) along with an appropriate step stool can encourage children to spontaneously try toileting. Getting a potty long before your child is ready results in it being as natural a part of the bathroom as the toilet itself. For kids who don’t like dramatic change, this may be helpful.

  6. Pomp and Circumstance. For kiddos who love to have their milestones celebrated in style, novelty toilets with their favourite characters on it may help. But more importantly, the positive and genuinely pleased approach you take towards their learning may make a longer term impact (and transfers over into all sorts of achievements and milestones without the need to surround yourself with Paw Patrol paraphernalia). Being interested and excited—without been too interested and excited—may take some trial and error. Knowing your child’s temperament, and what works for them in terms of your reaction to other achievements, can help guide you.

  7. Go with the Flow. Whether your child goes diaper-free or bottomless for three intense days in the winter, or for two months in the summer, there will likely be wet clothes and pee on the floor at some point. Cleaning it up without chastising, and (if you can muster it without it seeming like you are punishing them) recruiting their help in a calm way is important for avoiding shame and embarrassment about a tricky developmental skill that will inevitably have its ups and downs.

  8. Know when to hold’em… know when to walk away. If things are not going so smoothly, it is often a sign that they are not ready. Put the goal of potty training aside for a while, and return to it when there are other cues. If, however, you feel like there is more going on, pursue it with your doctor. Urinary tract infections can sometimes be symptom free and yet will cause all sorts of upsets to the progression of potty training.

  9. Natural Opportunities and Oops’s: At one point in the gradual transition to full toileting with my first born, I found myself at a park ten minutes from home when he had to go pee —and we had not brought a diaper with us. This was the first time in the toilet-learning process that he’d been away from home for toileting and he wasn’t so gung ho about the idea of peeing in the public washroom. I offered a choice: he could either pee in the public toilet or we go home right away for him to pee there and remain at home. Although not initially happy with this choice (it was a beautiful day at the park, but boy oh boy the toilet at home was familiar) he weighed his options and chose to give the public toilet a try. It worked! We got to stay another hour, and he overcame the milestone of using a washroom other than our own. The next week, however, at the same park, we ended up with a surprise wet pair of pants. Sometimes natural opportunities (or genuine forced choices) help us make progress. But it’s not always linear.

  10. Dry Nights. If dry diapers at night seem like a distant dream, and you feel like it ought to have happened already, consider constipation. If children are backed up (even if they are pooping every day), it can cause night wetting. If you feel this may be a factor, an x-ray can confirm it, and strategies can be put in place to get things flowing better. Once the bowels are emptying easily and fully, there is less pressure on the bladder and ureter, and more ‘room’ for developmentally-appropriate night dryness. Resolving constipation will also set the stage for smooth transition to toileting for bowel movements too.

When Hurdles Get In the Way

There are a number of situations that delay toileting or that prevent independent toileting. Mobility issues, neurodevelopmental and social-emotional challenges, frequent UTIs, and cognitive delays can impact a child’s ability to progress towards independent toileting. Whether these hurdles are resolved over time (e.g. cognitive development or resolving UTIs) or whether these hurdles remain, respecting a child’s developmental, emotional, and physical abilities is crucial. By appreciating what the challenge is, we as parents may work towards remaining calm about the goal, the timeline, and the barriers.

This patience and acceptance includes when the child is ready and willing emotionally and yet is unable to achieve this milestone, and vice versa —when the child appears physically able but is not emotionally ready.

Signs Your Child May Be Ready for More Progress to Toileting:

  1. Their diaper remains dry for a greater length of time;

  2. They pause activity and take a pee posture (or expresses to you verbally that they are peeing in their diaper) that lets you know they are peeing willfully;

  3. They show an interest in the toilet, especially if it involves imitating you. (However, imitating can happen long before a child is ready physically.) Encourage this imitation, even if it doesn’t ‘yield results’. Toilet habits are a nice thing to develop, if led by your child, even before toilet use is consistent.

Should I Use Rewards to Encourage Toileting?

I generally take an “Alfie Kohn” approach to rewards (see his book Unconditional Parenting for his perspective on rewards and punishment): rewards usually coerce compliance rather than support the development of a skill. Although a well-timed encouraging gesture can tip “almost ready kids” solidly into the “totally potty-trained” category, rewards tend to assume that all the pieces are in place for success, and that all the child needs is a sticker or toy or chocolate to achieve the milestone. This is not usually the case. Kids are built to want to develop new skills. If they are resistant to developing a new skill then perhaps (a) they are not ready yet and a reward will frustrate, rather than motivate, or (b) they are relying a lot on this skill being your priority rather than a priority that comes from within. Occasionally, a reward to sweeten the deal can be helpful in cases where there is a lot of fear —the extra motivation to overcome that fear might help. But in my view, we ought to use rewards sparingly.

All in Good Time

Generally, as with most developmental skills, if we as parents provide the environment (nurturing, supportive, with opportunities for development, and access to the right tools -e.g. a potty!) children will develop new skills when they are developmentally ready, including toileting. If the timing is right, this happens smoothly, albeit gradually and with set backs along the way. And although there may be pressure to speed things up and rush the process, we can remind ourselves that, just as with learning to walk, most kids will get where they need to go when they are ready.

Resources

Alfie Kohn, Unconditional Parenting

Built-In Potty Seat, amazon.ca

Mannekin Pis, bronze statue in Brussels, Belgium. Credit: Pixabay.

Mannekin Pis, bronze statue in Brussels, Belgium. Credit: Pixabay.

Normal Sleep from 6 to 12 months

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For those concerned about their infant's short naps and night waking, a new study led by Dr. Pennestri at McGill adds to our knowledge that:
-Interrupted sleep in infancy is normal. 
-Consolidated sleep happens gradually over time. 
-Interrupted sleep is not correlated with developmental issues (contrary to some previous studies).

Pennestri’s study coincides well with a much older study (Scher, 1991) that showed an increase likelihood of regular night waking at 9 months of age: although 40% of babes were waking up regularly at 6 months of age, this increased to 60% at the 9 month mark, dropping only slightly to 55% by 12 months of age. These studies explain what many parents have experienced at this age and explains why a significant number of my clients call me by the 10 month mark, concerned and exhausted! This bump in the road might be explained by the enormous social and emotional changes that are happening at this age.

What does this mean for you and your little one? 
1. Biologically normal night waking can be approached through perspective changes, self care, and environmental adjustments to help nudge children gradually towards longer sleep periods. 
2. Listen to your instincts about whether there may be an underlying issue (colic, reflux, environmental and food sensitivities) --these can all be sleuthed out and addressed to bring sleep more in line with your child's natural sleep needs.
3. Lean in to what is normal for babies and soak this intense, amazing, draining, and exciting time in as a season of parenting that can feel tiring, but does not need to feel terrible.
4. Call for support! Even if your baby is sleeping "normally", it can be helpful to have someone support your efforts through evidence, reflection, suggestions, and guidance. Sometimes the best intervention is through understanding.

Because there are significant (and often challenging) changes to infant sleep between 6 and 12 months, expect further articles of the research on “what is normal” for this age range soon! And even though it is hard to “rest” assured, most babes are shifting towards more regular and longer sleep periods by the one year mark. Better sleep is ahead!

Resources:

The McGill study, by Dr. Pennestri et. al., is in the December 2018 issue of Pediatrics. and is reported in McGill.ca, November 2018. Parents shouldn’t worry if their infant doesn’t sleep through the night by 6-12 months of age

Scher (1991). A longitudinal study of night waking in the first year. Child: Care, Health, and Development, 17 (295-302).


Photo Source: Pixababy yc0407206360

Photo Source: Pixababy yc0407206360

Even With Older Children, Attachment and Connection Support Sleep

A photo from quite a few years back of a relaxed and joyful part of our bedtime routine —hanging out together. Sleep is important. And so is connection. The two can work together. (It is recommended that children under two not bed share next to a sibling.)

A photo from quite a few years back of a relaxed and joyful part of our bedtime routine —hanging out together. Sleep is important. And so is connection. The two can work together. (It is recommended that children under two not bed share next to a sibling.)

There was a time before kids when I was not as attachment-focused in my sleep approach. And if I am completely honest with myself, there have been times even after becoming a mother where I have struggled with attachment-based approaches to supporting sleep. Shifting my perspectives and expectations this much has been a process.

But now, with my youngest at age 4, and with my two older boys, I’ve hit my stride (without perfection, but with calm intention) when it comes to supporting their sleep most nights.

Tonight’s bedtime routine (with all it’s imperfections, and bumps) feels like a story worth telling, in that it reflects how profoundly I’ve shifted my priorities around night time parenting. I don’t dismiss the importance of sleep (enough of it, and of good quality). But I do know that more often than not the best way for our kids to get good sleep is to meet (and exceed) the need with an open heart and a calm, unhurried state of mind.

Perhaps some nights an open heart and a calm, unhurried mind are a struggle. On those nights it’s a challenge to dig deep and meet the need. It becomes a war against our intentions, which often comes out looking like a battle against our kids: them resisting sleep, and us trying to overpower their resistance.

But tonight there was no strong arm, no temptation to coerce, and no resistance. Instead, the evening started with rather feeble efforts on my part to start the routine, and ended with a sense of such connection that I am smitten.

At the usual bedtime, as I do on nights when I am distracted and trying to get work done, I was verbally guiding my two older kiddos (6 and 9) to bed. But as with so many pieces of parenting, you’ve got to walk the walk….and actually walk with them upstairs! Instead, I was giving instructions about shutting down screen time while tapping on my laptop, and listing off bedtime steps without modelling them myself. Hardly “leading by example”.

Now I do know that my children are capable of walking up stairs independently. Of brushing their teeth independently. Of getting dressed independently. Of climbing into bed and crawling under the covers independently. But I have learned well both through research and through parenting experience, that the ability to do something independently is not the only factor in accomplishing a task. Not by a long shot. Coming alongside, and “doing with” are powerful strategies for connecting and accomplishing.

So instead of escalating the volume of my voice, getting sharper and snappier and frustrated, I paused, and heeded the call from my spouse to please come upstairs and help usher them to bed (we both play integral parts in the bedtime wind-down) —tonight things weren’t going all that smoothly. There seemed to be a frenetic energy in the upstairs loft (full moon?!). A lot was happening that had very little to do with bedtime. There were push ups and jumping jacks, karate punches and kicks into cushions, building of forts, requests to make elaborate paper plate faces to tape to these “punching bags” (yes that sounds terrific; yes, it will have to wait till tomorrow), and a lot (a lot) of talking.

But step by step, slowly and calmly, we made our way to their beds where story time was pulled off the roster but gratitude questions and a review of their day remained intact. By now it was very late and despite having more work to take care of, I lay with them a while, and I closed my kindle (did I say screens shouldn’t be part of bedtime? Direction not perfection!), and just lay there as my middle child told me elaborate explanations of how things work. He chatted while holding my hand. His volume was louder than usual, and we kept having to remind him that his little brother was sleeping. He talked with excitement and enthusiasm and while he talked he played with my hair. And then, interrupting his story, he requested that I get the detangling brush….so that he could brush the knots out of my hair.

Now the old me —before I became a mother, or before we got to a point where I was getting enough sleep most nights to make flexibility and patience easy— would have said no, it’s bed time, good night. But tonight I paused, considered how comfortable and content he was: he was getting one-on-one time with me as he peered at the full moon out his window and lazily shared contemplative explanations of zombies and werewolves.

Here was a kiddo whose one-on-one time often gets squeezed out between the needs of his younger brother and the activities of his older brother. The kiddo who sometimes stops talking out of frustration that no one is listening, or that he’s been interrupted again. Here he was chatting to me, connecting with me. So I did what I felt compelled to do: I got the comb, I brought it up, and he combed my hair while talking, while solving dilemmas of his day, while unwinding for sleep.

When all the knots were out I said good night, gave the boys kisses, and left. They both fell asleep without another peep.

There is something liberating about approaching night time this way. For all the conflict, or upset, or missed opportunities to connect during the day, night time has fewer distractions. Night time is a chance to put a cherry on top of the day, no matter how bad the day has been. Night time could be (and often is!) a stressful, exhausting ritual of resistance when we as parents can be maxed out. But by “finishing strong”, and finishing with connection, I’ve made up for some of the less-than-ideal parts of today.

Whatever needs he had not had filled during the day seemed topped up well by my spending this time with him as he lay in bed. And his need for sleep is fulfilled too: maybe not as early as ideal, but certainly as smoothly as I could ever wish for.

Snug as kittens: even older kiddos need to feel relaxed and to unwind with parental support sometimes.

Snug as kittens: even older kiddos need to feel relaxed and to unwind with parental support sometimes.